A Randomized Trial of the Topical Effect of Antifibrinolytic Epsilon Aminocaproic Acid on Coronary Artery Bypass Surgery Without Cardiopulmonary Bypass

We assessed the effect of the topical application of epsilon-aminocaproic antifibrinolytic acid (EACA) on the pericardium of patients submitted to coronary artery bypass graft (CABG) without the use of cardiopulmonary bypass (CPB). This is a prospective, randomized, and double-blind study. We evaluated 26 patients with chronic coronary heart disease indicated for CABG without CPB (EACA and placebo groups). The analysis of the postoperative hematological results showed no difference between groups in hemoglobin and hematocrit. There was no difference between the groups regarding the postoperative bleeding through the drains in the first 24 hours, 48 hours, and accumulated loss until removal of drains. The use of EACA in patients undergoing CABG without CPB presented no difference in the reduction of the amount of bleeding and the need for blood transfusions.

Vertebral spine of Tamandu-mirim Tamandua tetradactyla

Anatomical studies of the anteater (Tamandua tetradactyla) are scarce and the articles that describe the vertebral column of this species have variations in the number of thoracic and lumbar vertebrae. This study had the objective of adding data to the existing literature about the anatomical composition of an anteater's vertebral column using radiographic and tomographic exams. Based on the cadaver of a young female anteater, we observed a total of 7 cervical, 16 thoracic, 3 lumbar and 5 sacral vertebrae, which differed from the cited literature, especially with respect to the thoracic vertebrae. This demonstrates the need for studies with a larger number of individuals in order to standardize possible anatomic variations for the species.

Mensuração das dimensões cardíacas pelo método VHS (Vertebral Heart Size) em cães

It is imortant to be able to evaluate the cardiact size . In 1995, was proposed by Buchanan and Bücheler a new way to measure the dimensions of the cardiac silhouette. This study aims to gather several studies of the cardiac dimensions by VHS method in the right lateral recumbency of of different breeds of dogs in a single work, facilitating the assess to information. Deep chest breeds have a smaller mean VHS value than the barrel chest breeds, showing that there is a variation of the VHS values acoording to the thoracic conformation of each breed, which indicates that there is a need to recognize the specific VHS values according to the breed standard to not to interpret the cardiac measurement in a wrong way through not compatible reference values for the animal. There is the individual variation that should be taken into accont at the time of measurement. The VHS is a helper method to a radiographic evaluation of the heart, and the ultrasonography remains the gold standard for the evaluation of the cardiac chambers and other changes of the heart

Osteopatia como meio terapêutico nas disfunções temporomandibulares e dores orofaciais

Pós-graduação em Biopatologia Bucal - ICT

Frequency and clinical predictors of coronary artery disease in chronic renal failure renal transplant candidates

Background/aims: Cardiovascular diseases are major causes of mortality in chronic renal failure patients before and after renal transplantation. Among them, coronary disease presents a particular risk; however, risk predictors have been used to diagnose coronary heart disease. This study evaluated the frequency and importance of clinical predictors of coronary artery disease in chronic renal failure patients undergoing dialysis who were renal transplant candidates, and assessed a previously developed scoring system. Methods: Coronary angiographies conducted between March 2008 and April 2013 from 99 candidates for renal transplantation from two transplant centers in Sao Paulo state were analyzed for associations between significant coronary artery diseases (>= 70% stenosis in one or more epicardial coronary arteries or >= 50% in the left main coronary artery) and clinical parameters. Results: Univariate logistic regression analysis identified diabetes, angina, and/or previous infarction, clinical peripheral arterial disease and dyslipidemia as predictors of coronary artery disease. Multiple logistic regression analysis identified only diabetes and angina and/or previous infarction as independent predictors. Conclusion: The results corroborate previous studies demonstrating the importance of these factors when selecting patients for coronary angiography in clinical pretransplant evaluation.

The mediating role of physical inactivity on the relationship between inflammation and artery thickness in prepubertal adolescents

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Functional neurologic recovery in two dogs diagnosed with severe luxation of the vertebral column

Traumatic injuries to the vertebral column, spinal cord, and cauda equina nerve roots occur frequently in human and veterinary medicine and lead to devastating consequences. Complications include partial or complete loss of motor, sensory, and visceral functions, which are among the main causes of euthanasia in dogs. The present case report describes neurological functional recovery in two dogs that were treated surgically for severe spinal fracture and vertebral luxation. In the first case, a stray, mixed breed puppy was diagnosed with thoracolumbar syndrome and Schiff-Scherrington posture, as well as a T13 caudal epiphyseal fracture with 100% luxation between vertebrae T13 and L1; despite these injuries, the animal did show deep pain sensation in the pelvic limbs. Decompression through hemilaminectomy and spinal stabilization with vertebral body pins and bone cement were performed, and the treatment was supplemented with physiotherapy and acupuncture. In the second case, a mixed breed dog was diagnosed with a vertebral fracture and severe luxation between L6 and L7 after a vehicular trauma, but maintained nociception and perineal reflex. Surgical stabilization of the spine was performed using a modified dorsal segmental fixation technique Both patients showed significant recovery of neurological function. Complete luxation of the spinal canal observed radiographically does not mean a poor prognosis, and in some cases, motor, sensory, and visceral functions all have the potential for recovery. In the first case the determining factor for good prognosis was the presence of deep pain perception, and in the second case the prognosis was determined by the presence of sensitivity and anal sphincter tone during the initial neurological examination.

Pseudoaneurysm of the internal carotid artery presenting with massive (recurrent) epistaxes: a life-threatening complication of craniofacial trauma

Vascular lesions can be serious complications resulting of blunt or penetrating trauma(1,2). Internal carotid artery lesion is one of most serious and relatively frequent in all mechanisms of craniofacial trauma. Several clinical manifestations can occur as central neurologic and cranial nerves deficits as well as several degrees of bleeding (from mild symptomatic to fatal). Recurrent and massive epistaxis can occur after trauma due to pseudaoneurysms of the external and internal carotid artery (ICA)(3,4). Considering its life-threatening course, the assisting physician has a relatively narrow time to detect and treat these lesions.We present two cases of recurrent and massive epistaxis secondary to ICA pseudoaneurysm following blunt and perforating trauma. Evolution was fatal in the first case with delayed treatment and uneventfully in the second which was treated by occlusion of the pseudoaneurysm and ICA via endovascular intervention.

Internal carotid artery pseudoaneurysm after tonsillectomy treated by endovascular approach. A case report

Surgery on the head and neck region may be complicated by vascular trauma, caused by direct injury on the vascular wall. Lesions of the arteries are more dangerous than the venous one. The traumatic lesion may cause laceration of the artery wall, spasm, dissection, arteriovenous fistula, occlusion or pseudoaneurysm. We present a case of a child with a giant ICA pseudoaneurysm after tonsillectomy, manifested by pulsing mass and respiratory distress, which was treated by endovascular approach, occluding the lesion and the proximal artery with Histoacryl. We reinforce that the endovascular approach is the better way to treat most of the traumatic vascular lesions.

Influence of cardiac rehabilitation in Primigravida with spontaneous coronary artery dissection during postpartum

The physical exercise consists of trainable physical abilities such as strength and endurance. It can be inferred that the individual cardiac patient is dependent on it as an associated therapy to the drug treatment for a rapid and lasting improvement of their overall clinical status. The patient - with Spontaneous Coronary Artery Dissection Postpartum period - was subjected to 21 sessions of cardiac rehabilitation. A physical evaluation was performed, before and after the treatment period, for data collection: anthropometric values, flexibility, aerobic capacity and strength of grip. The patient had a positive response in aerobic capacity, flexibility and grip strength and the anthropometric values were kept in short term rehabilitation.

Postura de trabalho relacionada com as dores na coluna vertebral em trabalhadores de uma indústria de alimentos: estudo de caso

This study has as main objective to identify the complains occurrences about pain in the spine segments, that are related to work standing posture, adopted by the collaborators in the production section of a food industry, in the city of Marília São Paulo state. A descriptive research and studying case was made, using 30 employees as a sample. It was used as methodological procedure, a questionnaire to obtain information on professional and personal data, posture to remain standing, the most uncomfortable postures in the work environment (signed by the form of Ranney, 2000) and pain (pointed out by Corllet and Manenica Diagram, 1980). It was also used the Nordic questionnaire (Kuorioka et al.,1986), validated in the Brazilian culture by Barros e Alexandre (2003) and adapted for the study, the direct evaluation and, a direct observation was made in the production work, a posture analysis using the OWAS Method. It was noticed that the posture of standing up is adopted during work, and 73.3% of the people that was interviewed said that they felt tired in consequence of this posture, especially when associated with trunk twists, trunk inclination and elevation of their arms above their heads. Most complains regarding pain through their bodies, by Corllet e Manenica (1980) pointed to the lumbar region, followed in the dorsal area and legs and in the neck area, shoulders and right thigh. The adapted Nordic questionnaire reveled the lumbar area, in 10 interviewed people (33.3%) as the area mostaffected by musculoskeletal symptoms, next in the dorsal area, with five people interviewed (16.7%) and one of them (3.3%) felt pain in the cervical area, none reported pain in the hips area. The postural analysis was applied using OWAS method, and it was identified the postures that demanded more effort in the four levels of musculoskeletal injuries. As conclusion, the standing up posture and the asymmetric and incorrect movements are related to pain in the spine, mostly in the lumbar area.

Unfavorable iliac artery anatomy causing access limitations during endovascular abdominal aortic aneurysm repair: application of the endoconduit technique

Endovascular aneurysm repair (EVAR) is already considered the first choice treatment for abdominal aortic aneurysms (AAA). Several different strategies have been used to address limitations to arterial access caused by unfavorable iliac artery anatomy. The aim of this report is to illustrate the advantages and limitations of each option and present the results of using the internal endoconduit technique and the difficulties involved.